Apr. 18, 2010 In the Inland Empire locale of Southern California, failure to detect breast cancer in its early, more treatable stages is common among black women, and researchers have discovered that the cause may be a combination of incidence and mortality patterns, poverty, and a lack of medical insurance and education.
"Poverty and health care are intertwined, although large geographical areas such as San Bernardino County have the resources to effectively serve minority women," said Padma P.Tadi-Uppala, Ph.D., an associate professor in the department of environmental and occupational health at Loma Linda University, School of Public Health.
"The government and public health institutions should actively engage in identifying areas of need to serve minority women, reduce the breast cancer burden and ensure quality care regardless of race, ethnicity or socioeconomic status," she said.
While breast cancer mortality has declined by 31 percent overall in California, data for 2003 through 2007 indicated that mortality rates are significantly higher in women from the Inland Empire compared to the overall average in California.
About 2 million women live in the Inland Empire, an area that spans more than 27,000 square miles, according to the researchers. With funding from Susan G. Komen for the Cure, Inland Empire Affiliate, Tadi-Uppala and colleagues identified factors that may contribute to the unequal burden of breast cancer in the Inland Empire.
The mortality rate for breast cancer was 34.3 deaths per 100,000 non-Hispanic black women compared to 27 deaths per 100,000 non-Hispanic white women. Combining data for all race/ethnicity groups, the average annual age-adjusted mortality rate for breast cancer was 25.4 deaths in the Inland Empire compared to 22.8 deaths per 100,000 women statewide.
"Although this difference is slight, the higher risk of death from breast cancer in the Inland Empire is consistent with later detection of this screening-detectable cancer among these women," Tadi-Uppala said.
Non-Hispanic white women had a higher-risk of death from breast cancer than the statewide average. Results also showed the following:
- approximately 11.6 percent of homes had an income below poverty level;
- 24 percent of participants (mostly black and Latina) aged 16 to 64 years were uninsured;
- approximately 60 percent were not educated about breast health;
- 71 percent over 40 years of age did not have a mammogram in the last year; and
- nearly 80 percent were willing to participate in breast cancer clinical trials, but were not given opportunities to do so.
Tadi-Uppala and colleagues are currently working to educate minority women about the importance of participating in clinical trials, to recruit minority women into clinical trials, and to address lifestyle factors that affect breast cancer among minority women in the Inland Empire.
"We hope funding will be available to schools of public health such as ours that engage in community-based participatory research to reduce breast cancer incidence, morbidity and mortality among minority women who our research demonstrates currently experience an unequal burden of cancer," she said.
This research was recently presented at the American Association for Cancer Research 101st Annual Meeting 2010.
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